| National Provider Identifier [NPI]: | 1205163169 |
| Last Name Of The Provider | RENDON |
| First Name Of The Provider | ALICIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 NEAL ZICK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILLARD |
| Zip Code Of The Provider | 448909287 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 863 |
| Number Of Medicare Beneficiaries | 255 |
| Total Submitted Charge Amount | 83247 |
| Total Medicare Allowed Amount | 45240.92 |
| Total Medicare Payment Amount | 30316.3 |
| Total Medicare Standardized Payment Amount | 38203.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 168 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 5475 |
| Total Drug Medicare AllowedAmount | 2086.29 |
| Total Drug Medicare PaymentAmount | 1989.12 |
| Total Drug Medicare Standardized Payment Amount | 1989.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 695 |
| Number Of Medicare Beneficiaries With Medical Services | 255 |
| Total Medical Submitted Charge Amount | 77772 |
| Total Medical Medicare Allowed Amount | 43154.63 |
| Total Medical Medicare Payment Amount | 28327.18 |
| Total Medical Medicare Standardized Payment Amount | 36214.44 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 147 |
| Number Of Male Beneficiaries | 108 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 239 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0078 |